Provider Demographics
NPI:1962452953
Name:MCGORRY, DENNIS M JR (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:M
Last Name:MCGORRY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3050 HAMILTON BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3691
Mailing Address - Country:US
Mailing Address - Phone:610-432-2013
Mailing Address - Fax:610-432-6559
Practice Address - Street 1:3050 HAMILTON BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3691
Practice Address - Country:US
Practice Address - Phone:610-432-2013
Practice Address - Fax:610-432-6559
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD417458207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50000330OtherCAPITAL BLUE CROSS
PA080184709OtherPALMETTO RR
PA1404712OtherHIGHMARK PA BLUE SHIELD
PA1404712OtherHIGHMARK PA BLUE SHIELD
PA080184709OtherPALMETTO RR